College of Nursing, Seoul National University, Seoul 03080, Korea.
Research Institute of Nursing Science, Seoul National University, Seoul 03080, Korea.
Int J Environ Res Public Health. 2021 Mar 24;18(7):3363. doi: 10.3390/ijerph18073363.
Hypertension has been identified as the most prevalent chronic disease, accounting for the majority of premature deaths in people with physical disability in South Korea. Self-care is vital in controlling high blood pressure. Health literacy has been implicated in self-care behaviors; however, the mechanisms behind this relationship remain unclear. Therefore, the present study aimed to test a hypothetical path model estimating the association between health literacy and hypertension self-care behaviors and to verify the mediating effects of access to healthcare, provider-patient interactions, hypertension knowledge, and hypertension control self-efficacy in hypertensive people with physical disability. In total, 211 hypertensive adults with physical disability completed an online survey. A path analysis using a multi-mediation model was performed using AMOS 17.0 (IBM SPSS Inc., Chicago, IL, USA), and indirect effects were estimated using phantom variables. As a result, the model fit indices were deemed excellent. Significant indirect pathways were determined from health literacy to hypertension self-care behavior via provider-patient interactions, knowledge, and self-efficacy, although no direct association was found between health literacy and self-care behaviors. The study findings supported the importance of provider-patient interactions, knowledge, and self-efficacy, which play a role in linking health literacy and self-care behavior in hypertensive patients with physical disability.
高血压已被确定为最普遍的慢性病，占韩国身体残疾人群中大多数过早死亡的原因。自我护理对于控制高血压至关重要。健康素养与自我护理行为有关；然而，这种关系背后的机制尚不清楚。因此，本研究旨在测试一个假设的路径模型，该模型估计健康素养与高血压自我护理行为之间的关联，并验证在患有身体残疾的高血压患者中，获得医疗保健、医患互动、高血压知识和高血压控制自我效能在其中的中介作用。共有 211 名患有身体残疾的高血压成年人完成了在线调查。使用 AMOS 17.0（IBM SPSS Inc.，芝加哥，IL，美国）进行路径分析，使用虚拟变量估计间接效应。结果，模型拟合指数被认为是优秀的。虽然在健康素养和自我护理行为之间没有直接关联，但从健康素养到高血压自我护理行为的显著间接途径是通过医患互动、知识和自我效能确定的。研究结果支持医患互动、知识和自我效能的重要性，它们在将健康素养与身体残疾的高血压患者的自我护理行为联系起来方面发挥了作用。
